CQC report explained · a residential care home
What the CQC found at The Chestnuts
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, detailed risk assessments, safe medicines systems and clean premises.
- Effective?
- Good
- Staff had the skills and training to meet people's needs. People were supported with food, healthcare, communication, consent and decisions made under the Mental Capacity Act.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in decisions and encouraged to build relationships and do things for themselves.
- Responsive?
- Good
- Care was highly personalised and reflected people's choices, interests and communication needs. People were supported to take part in community life and to raise complaints.
- Well-led?
- Good
- Inspectors found open communication, supportive leadership and effective checks on care quality and safety. Staff understood how to raise concerns and learn from incidents.
What inspectors found, April 2019
The Chestnuts was rated Good in all five areas; inspectors found kind, personalised care and strong support for independence.
The inspection was unannounced and took place on 21 March 2019. One inspector spoke with five people living at the home, three staff members and two professionals. They observed care and checked care records, medicines records, staff information and management checks.
The inspectors found people were safe, treated with kindness and supported by staff who knew them well. Care plans were detailed and personal. People were supported to make choices, communicate their wishes, take positive risks and live as independently as possible.
The home was rated Good for Safe, Effective, Caring, Responsive and Well-led. The report says people's outcomes were consistently good, their needs were met through good organisation, and the home was consistently managed well. The previous inspection rating was also Good.
Kind and consistent staff
Staff knew people well and showed warmth, empathy and compassion. The report also noted a low staff turnover, supporting continuity for people.
“Staff had real care and empathy and knew people well. Staff were extremely caring, kind and compassionate.” from the report
Personalised care
Care plans described people's needs, preferences, health, routines and interests in detail. Records used personal pictures to help people understand their plans.
“Care records reflected people's needs thoroughly and in a person-centred way.” from the report
Independence and choice
People were encouraged to make decisions, take positive risks and do as much as possible for themselves. Staff supported people to try new experiences and take part in household tasks.
“People were supported to take positive risks and be as independent as possible.” from the report
Open and supportive leadership
Staff felt able to discuss incidents and concerns openly. The manager used audits, meetings, complaints and incident reviews to support improvements.
“There was a transparent culture where staff felt able to discuss issues or incidents in an open way.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you support my relative to communicate their choices and wishes if they cannot express them clearly?
- 02How do you balance independence and positive risk-taking with keeping people safe?
- 03How would my relative be involved in choosing their daily activities, staff support and community activities?
- 04How do you make sure there are enough suitably trained staff to support activities inside and outside the home?
- 05How would you support my relative or our family to make a complaint in a format they can understand?
This was an unannounced scheduled inspection covering the home, the care provided and all five CQC questions. This explanation was written from the published report of 30 April 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2016
Rated Good; inspectors found safe, kind and personalised care, but staffing pressures affected stability and some activities were not recorded.
This was an unannounced inspection on 27 and 29 September 2016. One inspector spoke with the manager, four support staff and two people using the service. The inspector also observed four people and checked care records, staffing, medicines, training, complaints and quality checks.
All five areas were rated Good: safe, effective, caring, responsive and well-led. Inspectors found people were supported by staff who knew their routines and needs. Care plans were personalised, medicines were managed safely, and people were supported with health care, food, activities and contact with family and friends.
There were some pressures. The home relied heavily on bank and agency staff, and one day the planned mid-shifts could not be covered. Staff supervision had some gaps, and not all planned activities took place or were recorded. The report said these issues were being reviewed.
Kind and respectful staff
Inspectors observed positive interactions. Staff understood people's routines, asked permission and supported privacy, dignity and independence.
“People were supported in a dignified and respectful manner.” from the report
Safe medicines and safeguarding
Staff were trained in safeguarding and medicines. Medicines competencies were checked annually, and safeguarding concerns were shared appropriately.
“Medicines policies and procedures were followed and medicines were managed safely” from the report
Activities and relationships
People were supported with activities in the home and community, including social clubs, walks and holidays. Staff helped people maintain contact with family and friends.
“People were supported to take part in regular activities both in the home and the community.” from the report
Reliance on temporary staff
needs fixingThe home relied heavily on bank and agency staff because some staff were supporting a person elsewhere. On the first inspection day, planned mid-shifts could not be covered, which made activities harder to plan.
“There was a lot of bank and agency staff usage.” from the report
Activity records
minorSome planned activities did not take place, and staff did not always record the activities people completed. The manager said this would be reviewed.
“They were also aware that staff did not always record the activities that people took part in.” from the report
Management pressure
needs fixingThe manager was temporarily responsible for another service. Staff said the divided management arrangements had affected morale and stability, although they expected this to improve when staff returned.
“This had an effect on the morale of staff and meant often they were working with either bank or agency staff.” from the report
- 01How many bank and agency staff are used now, and how often do they work in the home?
- 02Did the staff supporting the other service return as planned on 31 October 2016?
- 03How do you make sure planned mid-shifts are covered so people's activities can go ahead?
- 04How often do staff now receive supervision, and how are missed meetings followed up?
- 05How are people's activities recorded, and what happens if an activity in their plan cannot take place?
This was an unannounced comprehensive inspection covering all five CQC questions, based on discussions, observations and checks of care and service records. This explanation was written from the published report of 25 October 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Chestnuts
2 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 11 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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39 live-in carers within about an hour of South Gloucestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,280 a week. 32 can care for a couple. 11 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.